Vasoepididymostomy Ups Patency in Obstructive Azoospermia

Epididymal fullness, bilateral surgery, distal anastomosis, fluid with motile sperm up success

WEDNESDAY, Jan. 4 (HealthDay News) -- For men with idiopathic obstructive azoospermia, longitudinal intussusception vasoepididymostomy (LIVE; microsurgical vasoepididymostomy) achieves good patency rates, according to a study published in the January issue of Urology.

Jing Peng, M.D., from the Peking University First Hospital in China, and colleagues investigated the factors associated with the patency rates of LIVE in 73 men with idiopathic obstructive azoospermia (mean age, 30.9 years). Data from the participants were evaluated from January 2009 to July 2010. The mean follow-up for 72.6 percent of participants was 13.5 months. Data were analyzed based on pre- or intraoperative clinical findings, including epididymal fullness, epididymal fluid findings, unilateral or bilateral procedure, and anastomosis site.

The investigators found that there was an overall patency rate of 71.7 percent (38 participants). Epididymal fullness, bilateral surgery, corpus anastomosis, caudal anastomosis, and flowing fluid with motile sperm had patency rates of 87.2, 80.7, 78.8, 100, and 83.7 percent, respectively. At a mean follow-up of 9.9 ± 4.2 months, there was a natural pregnancy rate of 33.3 percent.

"LIVE should be the primary therapeutic method for cases of azoospermia due to epididymal obstruction. Epididymal fullness, bilateral surgery, distal epididymal anastomosis, and motile sperm with flowing epididymal fluid might be factors associated with surgical success. A surgeon can use these factors to assess the potential outcome," the authors write.

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